Policyholder Services

What is meant by “liability limits”?

Liability limits are the maximum dollar amount of damages (“indemnity”) an insurance carrier will pay on your behalf.  Limits are broken down into two categories: the per claim limit and the aggregate limit.  For each claim, the carrier will pay for all damages up to a maximum of the amount listed as your “per claim” limit.  The “aggregate” limit applies to all claims reported during the policy year or extended reporting period.  For example, if your limits are $1,000,000 per claim/$3,000,000 aggregate, your carrier will pay up to $1,000,000 in settlement or award for each professional liability claim and up to $3,000,000 for all claims reported that year.  With OMIC, as with most carriers, reasonable defense costs are paid in full and are not included within the liability limits.

What should I consider in deciding the limits I should carry?

To help you determine which limits are most appropriate for your practice, OMIC account representatives can provide you with statistics regarding the limits of liability carried by most insureds, OMIC’s average indemnity payment, OMIC’s highest indemnity payment, and your state’s risk relativity in relation to other states. The most commonly carried professional liability limit is $1,000,000 per claim/$3,000,000 aggregate, but OMIC offers an array of limits, from $500,000 per claim/$1,500,000 aggregate to $5,000,000 per claim/$10,000,000 aggregate.  Lower limits of $100,000/$300,000, $200,000/$600,000, and $500,000/$1,000,000 are available to physicians who participate in their state’s patient compensation or excess liability funds (Louisiana, South Carolina, and  Nebraska, respectively). You may generally request an increase or decrease in your limits of liability at any time during the policy period.  All requests for limit changes are subject to underwriting review and approval.

If I practice in New York, will I qualify for free excess coverage?

Licensed New York physicians may qualify for a free million-dollar excess policy from the hospital of their primary affiliation via the New York State Hospital Excess Liability Pool, but only if they are insured through carriers that are licensed and admitted in New York. Although Risk Retention Groups are authorized by the Federal Risk Retention Act to do business in New York, the Excess Liability Pool does not recognize Risk Retention Groups as valid primary carriers for the excess liability program. While OMIC insureds are ineligible to participate in the New York State Hospital Excess Liability pool, they may purchase limits of up to $5,000,000 directly from OMIC.

Updated 10/28/2021